27 Systemic Mycoses 1 Flashcards
Endemic mycoses share some features. These are? (6, review more than memorize)
-In nature-In a geographic region-Inhale->lungs->dissemination-human-human transmission almost never occurs-often asymptomatic-healthy CAN be infected
A bronchoscopic biopsy grows mold 5 days after visiting California central valley. I’ve got fever, chest pain, cough, night sweats. What do I have?
Coccidioidomycosis
Doc, what will happen to me now that I’ve got coccidioidomycosis? (3)
-asymptomatic (60%)-valley fever that goes away on its own (30%)-progressive lung nodules or dissemination
How is coccidioidomycosis diagnosed? (4)
-spherules on wet prep-BIOHAZARD for lab (like all dimorphics)-IgM or IgG in serum are useful for those NOT in endemic areas-hyphae w/ alternating barrel-shaped arthroconidia
coccidioidomycosis treatment?
usually not needed
A chimney sweep or a bat cave explorer comes to you w/ pneumonia symptoms. What is it?
histoplasmosis
Histoplasmosis pathogenesis?
inhale microconidia/spores ->budding yeasts in body -> get yeasts in macrophages (or disseminates by bloodstream)
Histoplasmosis symptoms?
-95% asymptomatic-Lung: either self-limited, or chronic cavitary fibrosing mediastinitis-Systemic: sepsis in immunocompromised
Histoplasmosis diagnosis?
-BIOHAZARD dimorphic: Giemsa stain & see yeast both extracellular and inside macrophages. (look like acorns)-Urine antigen test BEST
African histoplasmosis is caused by what organism?
histoplasma capsulatum var. duboisii
How is African histoplasmosis different than normal histoplasmosis?
-Larger, thick-walled yeast-Get giant cells-Less pulmonary involvement, but more bone/skin problems.
Histoplasmosis treatment?
Usually none. For severe: amphotericin B
Wisconsin! (or EAST U.S.) Lung, skin, & bone lesions, what fungus?
Blastomycosis[broad based budding!]
Blastomycosis is asymptomatic in what %?
1/2 (so high virulence for a fungus) (it can turn chronic in some!)
Blastomycosis diagnosis involves what?
-BIOHAZARD dimorphic. Wet prep, culture (which takes 4 wks!), or ELISA for exoantigen A.-Broad-Based Budding & lollipops coming off the hyphae!